Peter Kim

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

Practice address

1700 Medical Way
Snellville, GA 30078-2195

Phone

(770) 979-0200

NPI assigned

Sep 10, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Anesthesiology Assistant

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Group practices

Premier Anesthesia of Georgia LLCGroup PAC ID 6608123724, 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Premier Anesthesia of Georgia LLC

  • Anesthesiology Physician
  • Snellville, GA
  • NPI 1811403207

  Anesthesiologist Assistant

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Eastside Medical Center, LLC

  dba Piedmont Eastside Medical Center

  • General Acute Care Hospital
  • Snellville, GA
  • NPI 1467406132
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1457187163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 MEDICAL WAY",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 MEDICAL WAY",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782195",
            "telephone_number": "770-979-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "PETER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiara Kiah, RBT
• Deidre D. Kiefer, M.S./CCC/SLP/L
• Hye Jin Kim
• Jae Man Kim, PT
• Jonathan Kim, DDS
• Yong S Kim, M.D.
• Janelle Kimbrough, RBT
• Porsha Kimbrough, PMHNP
• Amy Duffy Kingry, CRNA
• Deborah Michelle Kirk, BS

• Anesthesiologist Assistant in Snellville, GA
• Providers in Snellville, GA by specialty
• Anesthesiologist Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.